• Title/Summary/Keyword: early intervention

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A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient (폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.372-377
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    • 2007
  • Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

An Ecological Survery of Early Childhood Nutrition in Whaseong-gun, Kyonggi-do (경기도(京畿道) 화성군(華城郡) 농촌(農村)의 유아영양법(乳兒營養法) 실태조사(實態調査))

  • Lee, Kyung Ja;Yi, Bo Sook;Mo, Sumi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.1
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    • pp.12-18
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    • 1983
  • An ecological survey of early childhood nutrition was conducted from January 23 to February 18, to study the feeding method and weaning practice in Whaseong-gun, Kyonggi-do. This study covered a total of 283 children. Seventy three percent of the subjects had been breast-fed; 10% had been bottle-fed; others had been combination-fed before the introduction of supplementary foods. Only 26.9% of the subjects began to be fed supplementary food before the age of 6 months. The supplementary food used most frequently by the majority of children at the beginning of weaning was plain cooked rice; rarely special preparation, or different from the food eaten by the family. As for age of termination of breast feeding, 42.7% of the subjects were before 12 months; 32.8% were between 13 and 18 months of age; 24.5% were more than 19 months old. As for methods of stopping breast feeding, 44.5% of the subjects were naturally terminated while 38.5% were forced to terminate by the application of sticking plaster or medicines to the mother's nipples. The results indicate a need for nutrition and hygiene intervention to improve the weaning practice of rural area through the community nutrition education.

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Emergency Cranial Irradiation Effects in Adult Leukemia with Extremely High Leukocytosis (극심한 백혈구 증다증이 동반된 성인 백혈병에 있어서 응급 두개부 방사선 조사의 효과)

  • Park Seoung-Ho;Cho Moon-June;Kim Samyong
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.255-259
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    • 1992
  • We have treated adult acute leukemia 64 patients between January 1990 and October 1991 at the Chungnam National University Hospital. They were examined for the impact of presenting WBC count on the initial course and from them we have chosen twenty patients whose leukocyte count is over one hundred thousands per cubic milimeter, We divided the twenty patients into 4 groups on the base of treatment modalities: conservative therapy only, chemotherapy only, cranial irradiation only, and chemotherapy with cranial irradiation. Early sudden death rate is lower in cranial irradiation with/without chemotherapy groups than the conservative only or chemotherapy only patients. Also the remission rate is high in cranial irradiation with chemotherapy patients. Therefore we suggest that the rapid intervention of cranial irradiation in adult acute leukemia could be helpful in reducing the early sudden death rate and perhaps in increasing the remission rate.

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Early Thoracotomy in the Treatment of Chest Trauma (흉부외상 치료에서 조기 개흉술)

  • 김한용;황상원;이연재;유병하
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.604-609
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    • 1998
  • Trauma to the thorax represents a significant portion of injuries seen in an inner-city emergency room. Although most of these patients may be sucessfully managed without thoracotomy, a certain percentage requires operative intervention either immediately or within several hours. 126 records of patients who had early thoracotomy for chest trauma from March 1986, to June 1997, in the Department of Thoracic and Cardiovascular Surgery in Masan Samsung General Hospital were reviewed. There were 96 males and 30 females whose ages ranged from 4 to 72 years, with a mean age of 32.8 years. The modes of injury were as follows : stab wounds, 55 cases(44%), blunt trauma, 70 cases(55%), and gunshot wound, 1 case(1%). Immediate operation was performed in 105 cases(84%) and delayed operation in 21 cases(16%). Indications that operation was necessary were hemorraging and shock in 66 cases(52%), cardiac tamponade in 27 cases(21%), and rupture of the diaphragm in 33 cases(27%). Most of these patients were sucessfully treated but 21 cases were resulted in death. The mortality rate was 16.6% and common causes of death were irreversible shock and hypoxia.

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Electroacupuncture Delays Development of Hypertension through Increase of NO Level in Spontaneously Hypertensive Rats

  • Hwang, Hye-Suk;Kim, Yu-Sung;Lee, Ji-Eun;Han, Kyung-Ju;Choi, Sun-Mi;Koo, Sung-Tae
    • Korean Journal of Oriental Medicine
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    • v.13 no.2 s.20
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    • pp.149-155
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    • 2007
  • Objective : Using a spontaneously hypertensive rat (SHR) model of essential hypertension, this study investigated whether electroacupuncture (EA) could reduce early stage hypertension by examining whether EA increased nitric oxide (NO) levels in plasma, which compensates for elevated blood pressure (BP). Methods : EA was applied to the acupoint, Baekhoe (GV20), and to a non acupoint in the tail at 10 Hz and an intensity of 1 mA for 10 minutes on the first and fourth day of the week for three weeks under isoflurane anesthesia. In conscious SHR and normotensive Wistar Kyoto (WKY) rats, blood pressure was determined the day after EA treatment by the tail cuff method using an automatic BP monitoring system. We also measured NO concentration of blood serum in SHR and WKY. Results : Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower after 3 weeks of GV20 treatment than in non EA treated or non acupoint treated SHR rats. The NO level of plasma was significantly lower in hypertensive SHR than in normotensive WKY. EA prevented the augmentation of blood pressure, and also increased NO concentrations from $7.91{\pm}0.42$ ${\mu}M$ to $11.50{\pm}0.93$ ${\mu}M$ in SHR serum. Conclusions : We suggest that acupuncture may be an early intervention to delay the development of hypertension and enhance NO/NOS activity.

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Results of Extracorporeal Membrane Oxygenation (ECMO) Support before Coronary Reperfusion in Cardiogenic Shock with Acute Myocardial Infarction

  • Chung, Eui-Suk;Lim, Cheong;Lee, Hae-Young;Choi, Jin-Ho;Lee, Jeong-Sang;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.273-278
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    • 2011
  • Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.

Gender Differences in Effects of Attention Deficit/Hyperactivity on Depression in Early Adolescence (초기 청소년기 우울에 대한 주의력 결핍·과잉행동의 영향에 있어서의 성별에 따른 차이)

  • Choi, Jung-Ah
    • The Journal of the Korea Contents Association
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    • v.14 no.11
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    • pp.285-297
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    • 2014
  • The purpose of this study is to examine the associations among attention deficit/hyperactivity, social withdrawal, peer relationships, and depression in early adolescence. Gender differences in the associations were also examined. This study investigated these relationships and the gender differences using structural equation modeling multi-group analysis. The third wave data from Korea Children and Youth Panel Survey (KCYPS) of fourth graders were analyzed. The results indicated that attention deficit/hyperactivity had significant effects on depression directly and indirectly through social withdrawal and peer relationships. These results suggest that new programs should be developed to prevent or alleviate depression associated with attention deficit/hyperactivity among adolescents. Specifically, social withdrawal and peer relationships need to be emphasized in planning prevention or intervention programs to promote mental health of adolescents with attention deficit/hyperactivity.

Usefulness and Limitation of Ultrasonography in the Diagnosis of Septic Arthritis of the Elbow in a Neonate (신생아 주관절 화농성 관절염의 초음파 이용의 제한: 증례 보고)

  • Park, Ji-Hun;Jeon, Woo-Joo;Jeong, Woong-Kyo;Lee, Soon-Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.112-117
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    • 2012
  • Septic arthritis of the elbow is a rare, but serious disorder in neonates. However, neonates often present with few systemic signs other than irritability or poor feeding. When the clinical findings are minimal or absent, joint aspiration gives us helpful information in making a diagnosis. Although many clinicians rely on its result, we experienced a case of early clotted joint effusion, which resulted negative joint aspiration in a neonate with septic elbow arthritis. Ultrasonography helped us to make an early decision to perform surgical intervention as showing different echogenicity of intracapsular portion from generally presented in septic effusion. Presenting case shows that ultrasonography can be an excellent second step examination of neonatal elbow presenting atypical clinical findings of septic arthritis.

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Multilevel Modeling Analysis of Developmental Changes in Early Adolescent Aggression and Family Factors (초기 청소년기 공격성의 발달적 변화와 가족 영향 요인에 대한 다층모형 분석)

  • Choi, Jung-Ah
    • The Journal of the Korea Contents Association
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    • v.14 no.2
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    • pp.294-307
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    • 2014
  • The purpose of this study is to examine the trajectory of early adolescent aggression and to assess the effects of perceived family factors on it. This study investigated the changes in aggression over time and the effects of three family factors, parental attachment, parental monitoring, and family conflict, on the changes using multilevel modeling. The data from Korea Youth Panel Survey(KYPS) of fourth graders who were followed over five years were analyzed. The results indicated that there was a significant average increase followed by a slight decrease in aggression over time; that is, the data followed a quadratic trend. Parental attachment, parental monitoring, and family conflict had significant time-independent effects on aggression, while only family conflict had a significant time-dependent effect on aggression. These results imply that family factors need to be emphasized in planning prevention and intervention programs to reduce aggression during adolescence.

Gender Differences in Marital Disruption among Patients with Cancer: Results from the Korean National Health and Nutrition Examination Survey (KNHANES)

  • Song, Hai-Yan;Kwon, Jeoung-A;Choi, Jae-Woo;Kim, Sun-Jung;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6547-6552
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    • 2014
  • Background: Cancer is a major life event that imposes huge economic and mental burdens on patients and families. In addition, the diagnosis of cancer also causes significant family discordance that can lead to marital problems such as divorce or separation. The aim of this study was to investigate the association and any related gender differences between cancer diagnosis and marital disruption among cancer survivors. Materials and Methods: We used the recent cross-sectional Korea National Health and Nutrition Examination Survey ($4^{th}$ and $5^{th}$; Years 2008-2012). The study participants were 623 married cancer survivors over the age of 19. A multivariate logistic regression analysis was conducted to estimate odds ratios. Results: After adjusting for socioeconomic status and health-related behaviors, the odds ratio of marital disruption among female cancer survivors compared with male cancer survivors was 3.94 (95%CI 1.30-11.94; p=0.02). The odds ratio of marital disruption for the below-average economic level compared with the above-average economic level was 5.64 (95%CI: 1.03-31.02; p=0.05). When compared with the non-smoking cancer survivors, the smoking cancer survivors had an OR of marital disruption equal to 2.94 (95%CI: 1.08-8.00; p=0.03). Conclusions: The findings of this study suggest that the odds of marital disruption among female cancer survivors are higher than those among their male couterparts. Medical practitioners should be sensitive to early signs of marital discord in couples affected by a cancer diagnosis. Early identification and psychosocial intervention might reduce the frequency of divorce and separation and thus improve quality of life and quality of care for cancer survivors.